His disease is explained by his high concentration of small dense LDL and
low concentration of HDL2.
The Lipoprotein
Panel reports four key risk factors which augment or replace those in a standard lipid
panel.
The risk categorization format is designed to mimic recommendations of the NCEP,
using cutpoints that correspond to NCEP cutpoints on a percentile equivalent basis. NMR
population percentile information comes from a study of over 3,400 subjects in the
Framingham Offspring Study.
The LDL Particle concentration cutpoints (units of nanomoles of particles per liter)
correspond to the 20th, 50th, and 80th percentile values. By analogy to NCEP
recommendations, the therapeutic goal for patients with CHD (secondary prevention) or
without CHD (primary prevention) should be LDL particle concentrations of <1100 or
<1400 nmol/L, respectively.
LDL Particle Size is the average diameter (in nanometers, referenced to electron
microscopy values) of the patient's LDL particles. Categorization of the patient as
pattern A (large LDL, lower risk) or pattern B (small LDL, higher risk) is based on a
cutpoint of 20.5 nm (>20.5 indicating pattern A), which is equivalent to the 25.5 nm
cutpoint used in most gradient gel electrophoresis studies.
Cutpoints used to define risk categories for Large HDL and Large VLDL are the 25th and
75th percentile values.